News analysis for November 15, 2021

Racial minority women and health workers struggle to find suitable respirators

Most respiratory protective equipment (RPE) used in healthcare is not designed for women or racial minorities amid a lack of research into how facial dimensions by gender and race affect people. ventilator performance, according to a systematic review and meta-analysis published late last week in BMJ Global Health.

Researchers at the University of Southampton in England led the study, which involved analyzing 32 studies and anthropometric data (measurements and proportions of the human body) from 15 studies.

Studies were included if they assessed half or quarter size filter respirator masks that meet N95 / PPF3 standards of any brand, design, model, size, or storage capacity. Investigators noted that PPE should be “tested for the fit” or evaluated for a good seal, in order to reduce inward leakage of aerosolized viruses such as SARS-CoV-2.

They found that most RPEs were developed for men and whites, who do not make up the largest proportion of National Health Service (NHS) staff in England. And 63% of COVID-19 deaths among NHS staff have been blacks and other racial minority staff, despite making up only 20% of the workforce.

Anthropometric analysis showed that the faces of women are significantly smaller than those of men. But while 12 studies reported a less well-fitting face mask for women than for men, 10 reported no gender differences.

The trends seen in studies that included racial minorities were similar, although few studies have focused on fit test differences between races. In 12 studies, a small or moderate number of racial minorities were able to find a suitable respirator for them.

The small sample size and lack of rationale, inclusion and exclusion criteria, and power calculations were a concern in many studies, the authors noted. “Significant heterogeneity in study designs limited comparisons, particularly with respect to the selection or availability of respirators and the definition of study results regarding RPE performance,” the researchers wrote.

In a press release from the University of Southampton, lead author Jagrati Chopra called for more research into the proper design of face masks and other personal protective equipment: “The high rate of BAME [Black, Asian, and minority ethnic] Healthcare workers affected by the pandemic have shown how important it is to have enough breathing equipment to suit everyone, regardless of gender or origin. “
12 november BMJ Global Health to study
November 12 University of Southampton Press release

Depressed patients went to emergency rooms more often for anxiety, chest pain in pandemic

Depression and anxiety during the COVID-19 pandemic have prompted more patients to seek emergency room (ED) treatment for anxiety and chest pain, according to a press release on an study to be presented tomorrow at the 2021 American Heart Association Virtual Scientific Conference. Sessions.

Researchers at Intermountain Healthcare in Salt Lake City examined 4,633 patients who had routine screening for depression before (March 1, 2019 to February 29, 2020) and during (March 1, 2020 to April 20, 2021) the pandemic. .

Almost 40% of patients said they experienced new or persistent symptoms of depression in the first year of the pandemic. Among depressed patients, screening scores were higher during rather than before the pandemic. The odds of visiting an emergency department for anxiety treatment were 2.8 times higher for depressed patients than non-depressed patients and 1.8 times higher for anxiety with chest pain.

Principal researcher Heidi May, PhD, said in the statement that longer-term follow-up is needed to identify possible long-term effects of the pandemic on mental health, as depression is a significant risk factor for illness. cardiovascular.

“If people get more depressed because of the pandemic, in a few years we could see a higher incidence of cardiovascular disease,” she said. “Clinicians need to be fully aware of the mental health of their patients so that it can be treated and treated immediately to improve the overall quality of their life and hopefully avoid the development of subsequent health problems in the future. . This is vital, because the pandemic is still not over. “
November 13 Intermountain Health Press release

Norway, UK and Japan report more H5N1 avian influenza in poultry

Norway reported its first-ever outbreak of highly pathogenic H5N1 avian influenza in poultry, and the UK and Japan have reported more detections of the virus, according to official reports and media.

In Norway, the outbreak began on November 10 at a farm in Rogaland County, on the country’s southwest coast, according to a notification from the World Organization for Animal Health (OIE). The outbreak also marks the first appearance of H5N1 in Norway.

Elsewhere in Europe, the UK Department for Environment, Food and Rural Affairs (DEFRA) has reported two more outbreaks of H5N1, one at a facility in North Yorkshire and the other at a site in nearby Lancashire . Both are in the north of England.

Meanwhile, Japan has reported its second bird flu outbreak in poultry, this time on a farm in Kagoshima Prefecture, according to a government statement translated and posted by Avian Flu Diary (AFD), a news blog. on infectious diseases. A news article citing an agricultural official indicated that the subtype is H5N1.

In an update from OFFLU, the OIE and Food and Agriculture Organization of the United Nations Animal Influenza Expert Network, the group said that 41 countries in Asia, Europe and Africa have reported detections in wild birds and poultry since May, with most viruses falling in the HA clade. Genetic sequencing of recent H5N1 viruses from Europe suggests that they are linked to recent H5N5 and H5N1 strains found in Europe and Africa in late 2020 and early 2021, all of which are linked to H5N8 circulating in Eurasia.
12 November OIE report on H5N1 in Norway
November 15 DEFRA
November 15 AFD
ProMED letter of November 12
Publish on the OFFLU declaration

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